Ronald Reagan UCLA Medical Center, David Geffen UCLA School of Medicine, University of California, Los Angeles, Los Angeles, California 90095, USA.
Ann Thorac Surg. 2012 Jan;93(1):348-55, 355.e1-6. doi: 10.1016/j.athoracsur.2011.10.036.
The Society of Thoracic Surgeons (STS) and the American Association for Thoracic Surgery (AATS) have intermittently surveyed their combined membership. These manpower surveys have provided snapshots of thoracic surgery, documenting practice changes over time. At this critical time in US health care reform the physician workforce is of critical importance. This survey updates the data obtained from the 2000 and 2005 surveys.
The survey instrument was updated from the 2005 survey. It was received by 5,265 surgeon members of the STS/AATS during November and December 2009. There was a superb 50% return rate. The data were entered into a comprehensive database. Perception Solutions, Inc, independently performed the analysis.
The median age of the active US thoracic surgeons is 52.9 years. Women comprise 3.4% of adult cardiac, 5.2% of congenital heart, and 7.9% of general thoracic surgeons. The decision to pursue a career in thoracic surgery was made before or in medical school by 45.3% of surgeons. The majority of survey respondents had a mean of 8.7 years of residency training after medical school graduation. The cumulative average educational debt was $56,000. Overall career satisfaction was 46% (very or extremely satisfied). Database participation was 84%. Operative volume over the past 12 months decreased for 30% of surgeons. Malpractice premiums have steadily increased over the past 5 years from $55,947 to $59,673. The number of additional years the currently active US cardiothoracic surgeon plans to practice is 12.6 years. Therefore, the projected retirement age of the thoracic surgery workforce will be 65. This is consistent among all surgeons: adult cardiac, 66 years; congenital heart, 65 years; and general thoracic, 67 years.
These data give a clear profile of the specialty at this time. The major challenges remain length of training and educational debt of the thoracic surgeon. Case volume, scope of practice, malpractice costs, and career satisfaction remain major elements to provide a positive environment to recruit new surgeons in to the specialty. The resident pool has contracted while the workforce ages and retirement looms. Significant shortages may develop as the US population ages in the environment of health care reform.
胸外科医师学会（STS）和美国胸外科学会（AATS）间歇性地对其联合会员进行调查。这些人力资源调查提供了胸外科的快照，记录了随着时间的推移实践的变化。在美国医疗改革的这个关键时刻，医师队伍至关重要。这项调查更新了 2000 年和 2005 年调查获得的数据。
调查工具是从 2005 年的调查中更新的。2009 年 11 月至 12 月期间，STS/AATS 的 5265 名外科医生会员收到了该调查。回复率非常高，达到了 50%。数据被输入到一个综合数据库中。独立的 Perception Solutions, Inc. 进行了分析。
美国活跃的胸外科医生的中位数年龄为 52.9 岁。女性占成人心脏外科医生的 3.4%、先天性心脏病外科医生的 5.2%和普通胸外科医生的 7.9%。45.3%的外科医生在医学院之前或期间就决定从事胸外科工作。大多数调查对象在医学院毕业后接受了 8.7 年的住院医师培训。累计平均教育债务为 56,000 美元。总体职业满意度为 46%（非常满意或极其满意）。数据库参与率为 84%。过去 12 个月，30%的外科医生手术量减少。过去 5 年来，医疗事故保险费稳步增加，从 55,947 美元增加到 59,673 美元。目前活跃的美国心胸外科医生计划再执业的额外年限为 12.6 年。因此，胸外科医生队伍的预计退休年龄为 65 岁。这在所有外科医生中都是一致的：成人心脏外科医生 66 岁；先天性心脏病外科医生 65 岁；普通胸外科医生 67 岁。
这些数据清楚地描绘了当前该专业的情况。主要挑战仍然是胸外科医生的培训时间和教育债务。手术量、执业范围、医疗事故成本和职业满意度仍然是为吸引新外科医生进入该专业提供积极环境的主要因素。随着胸外科医生队伍老龄化和退休迫在眉睫，住院医师人数已经减少。随着美国人口老龄化和医疗改革环境的发展，可能会出现严重的短缺。
